June 18th, 2018

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Obesity as a Risk for the Recurrence of Anterior Vaginal Wall Prolapse After Anterior Colporrhaphy
Authors:  Amie Kawasaki, M.D., Elizabeth G. Corey, M.D., Robin A. Laskey, M.D., Alison C. Weidner, M.D., Nazema Y. Siddiqui, M.D., M.H.Sc., and Jennifer M. Wu, M.D., M.P.H.
  OBJECTIVE: To determine whether obese body mass index is associated with the recurrence of anterior vaginal wall prolapse after anterior colporrhaphy.

STUDY DESIGN: We conducted a retrospective cohort study of the risk of recurrent anterior prolapse 6 months after anterior colporrhaphy in normal weight/overweight versus obese women from January 2004 to December 2010. Women who underwent a concurrent apical prolapse procedure were excluded. Data were abstracted regarding sociodemographics, physical examination, operative reports, and postoperative follow-up visits.

RESULTS: Of 282 subjects 192 (68%) were normal/ overweight and 90 (32%) were obese. Median time of follow-up was 1.8 months (interquartile range [IQR] 1.46.2) in the normal/overweight group and 2.0 months (IQR 1.45.9) in the obese group. The overall risk of recurrent prolapse was 15.2%. In bivariate analysis there was a trend towards higher recurrence in the obese versus the normal/overweight cohort (21.1% vs. 12.5%, p=0.06). In the logistic regression model, which adjusted for age, race, diabetes, constipation, cigarette use, concurrent sling, and prior hysterectomy, obesity became significantly associated with recurrent anterior prolapse (odds ratio 2.5, 95% confidence interval 1.25.3).

CONCLUSION: The risk of recurrence after anterior colporrhaphy is relatively high in the short-term. Obesity is associated with increased odds of anatomic recurrence of anterior vaginal wall prolapse.
Keywords:  anterior colporrhaphy, gynecologic surgery, obesity, pelvic organ prolapse, vaginal wall repair
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